Category Archives: Podcast

Medicare officials are touting a smaller-than-average increase in Part A and Part B premiums, adding that in some cases seniors will even pay less in 2012 than they did this year. Officials are linking the smaller increase to the slower spending growth for health services for seniors, due in part to the Affordable Care Act.

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Meanwhile, a new survey details potential cuts in access to care if the looming 29.5% Medicare pay cut goes into affect. Among the more than 2,000 physician group practices surveyed, more than half said they’d be taking fewer new Medicare patients.

For details on that and more, listen to this week’s Policy & Practice Podcast.

After much anticipation, the Centers for Medicare and Medicaid Services finally released the final rule on accountable care organizations. As physician and hospital groups were initially wary of ACOs, CMS said they’ve considered the suggestions and the rule was adjusted accordingly. Among other changes, interested physicians will now have more time to get an ACO up and running.

As the Joint Select Committee on Deficit Reduction, or the Supercommittee, works behind closed doors to find more than a trillion dollars in debt reductions, the American Medical Association is pulling out all the stops to get a permanent fix to the Sustainable Growth Rate Formula on the agenda. Whether the committee chooses to address the SGR issue, they have until Nov. 23 to get their recommendations out.

Meanwhile, the Obama administration has awarded nearly $300 million in scholarships and loan repayment to physicians willing to spend two to four years working in rural communities. The initiative is aimed at boosting the physician workforce shortage in under-served areas.

For more on that, take a listen this week’s Policy & Practice Podcast.

The Medicare Payment Advisory Commission (MedPAC) is recommending that Congress throw out the Sustainable Growth Rate (SGR) formula currently used in setting Medicare physician payments. Under that formula, physicians are due to have their Medicare payments cut by about 30% on Jan. 1. But while doctors are unanimous in their loathing of the SGR, there are differing opinions about how to solve the problems with how Medicare pays physicians.

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Check out the Policy & Practice podcast to hear how MedPAC wants to pay for its SGR fix and what objections physician groups are raising about the plan. This week’s podcast also features news on the Institute of Medicine’s recommendations on what should be included in an essential package of health insurance benefits for health plans operating in the state health insurance exchanges in 2014.

As the Supreme Court begins its new term today, speculation begins in earnest about how the high court might rule on the constitutionality of the Affordable Care Act.

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The Obama administration recently filed a petition asking the Supreme Court to review a lower court decision on the constitutionality of the Affordable Care Act. The 11th Circuit Court of Appeals in Atlanta had struck down the law’s requirement that individuals have insurance, because it violated the Commerce Clause of the Constitution. The appeals court decision would allow the rest of the Affordable Care Act to go forward.

Supporters of the Affordable Care Act aren’t the only ones looking to get the Supreme Court involved. A coalition of 26 states that is challenging the law has also petitioned the high court to review the decision of the 11th Circuit Court of Appeals. Those states want the Supreme Court to throw the health law completely.

The Supreme Court justices haven’t officially decided whether they will review the Affordable Care Act. But if they do take on the case, their decision is likely to come in the middle of the 2012 presidential campaign.

Hear more about the legal wrangling in the Oct. 3 edition of Policy & Practice podcast. This week’s podcast also includes new figures on rising health insurance premiums and the latest on a proposal from the Department of Health and Human Services to offer bonus payments to primary care physicians who spend more time with patients and provide intensive disease management.

The Super Committee — officially known as the Joint Select Committee on Deficit Reduction — sat down together officially for the first time last week. With their tight deadline and daunting task, some experts are expressing concern that Super Committee efforts will address the Sustainable Growth Rate formula.

In other SGR news, MedPAC commissioners heard one proposal on how to fix the SGR. While the proposal would lop $100 billion off the price tag for a fix, doctors of many stripes were not pleased with how the savings would be accomplished.

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Also, a new report from the Census Bureau showed that nearly 100 million more Americans were uninsured in 2010. However, 18- to 24-year-olds gained coverage. Census officials say that could be because of provisions in the new health law that keep young people insured through age 26.

In the first appellate court decision on health reform, a three-judge panel has ruled that the Affordable Care Act does not violate the Constitution. The ruling was in response to two lawsuits brought by Liberty University and by Virginia’s Attorney General, Ken Cuccinelli.

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Also, those pushing for an overhaul of the health system might be interested in a new study on physician pay that says that U.S. doctors are paid more than in several other nations. Researchers also found a pay gap between primary care and orthopedic physicians. (To see our story on this, click here.)

In other news, the Centers for Medicare and Medicaid Services has eased restrictions on requirements for electronic prescribing.

For details on that and more, check out this week’s Policy & Practice podcast.